How would you respond to the Medical Director’s Question?
First and foremost, therapeutic communication involves well thought out and emotional-free responses in order to effectively discuss the issue at hand. Considering the positive relationship help by the two involved in this case, I would hope that the nurse would not take the “Why did you tell me sooner?” as an attack, but as an opportunity to identify where the communication gap could have occurred.
What do you and the Medical Director need to do?
According to finkleman, “…collaborative relationships between nurses and physicians focus on mutual power, but typically the physicians power is greater.” The text goes on to mention, “In addition to power the relationship requires respect and trust between Nurse and Physician.” (Finkleman, 2016) A fine line must be drawn between the several years of good friendship and an identification of what the root cause of the issue, must be established. Well thought out planning and open communication is key in this scenario.
How can you avoid this being a we/they situation?
Role delineation and reminds of scope and work responsibilities regarding ethics, policies and guidelines must be first considered so that all parties involved can identify where they have room to improve. “Taking ownership of your role requires a solid understanding of where you fit in the organizational chart. That is, how does your role differ from that of the person to whom you report? If you're responsible for overseeing more than one department, you may find yourself reporting to more than one manager. When you have more than one person setting and/or defining expectations for you, it's helpful for each of them to understand your job description. The ANA provides a comparison framework for the nurse executive and the nurse manager, which is helpful when trying to gain a better understanding and appreciation for both positions.” (Para 5, Cohen, 2014)
How will you involve staff?
I believe the peer-reviews of behavior through the appropriate committees would be an optional step, however in a group setting share governance council could discuss more than just the isolated incident and the entirety of the unit’s morale, statistics of callouts, etc. could be discussed. This should involve both nurses and Physician levels of staff and be led by the Nurse Leader and Medical Director to demonstrate unity.
What can you do about the powerlessness staff feel?
The bible tells us in Deuteronomy 28:7 “The Lord will cause your enemies who rise against you to be defeated before you. They shall come out against you one way and flee before you seven ways.” NIV, 2016) The facility and staff should feel empowered by a certain standard of values and ethics to be comfortable speaking up and addressing their issues as a team prior to potential blow-ups and larger and more inappropriate means of addressing the frustrations.
Cohen, S. (2014). Owning your role. Nursing Management (Springhouse), 45(3), 8-10. http://dx.doi.org/10.1097/01.numa.0000443946.98997.0c
Finkelman, A. (2016) Leadership and management for nurses (3rd ed., p. 331). Boston, Ma: Pearson.
NIV (2016) – New International Version – Bible